Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan.
Toyama Regional Center for JECS, University of Toyama, Toyama, Japan.
Eur Psychiatry. 2023 Jan 24;66(1):e18. doi: 10.1192/j.eurpsy.2023.5.
Accumulating evidence suggests a long-term health risk of cesarean section for the mother and child, but few studies have examined the link between cesarean section and parenting stress. Here, we examined this association by exploiting a large dataset.
Participants were 65,235 mothers participating in the Japan Environment and Children's Study, an ongoing nationwide birth cohort. Outcome variables were parenting stress assessed as total score and subscale scores (representing the difficult child, parental distress, and spouse factors) on the Japanese 19-item version of the Parenting Stress Index Short Form (J-PSI-SF). Exposures were the mode of delivery, the timing of the J-PSI-SF assessment (1.5, 2.5, and 3.5 years postpartum), and the interaction between them. Multivariate regression analysis was used to calculate adjusted coefficients and standard error of the means (SEMs).
The J-PSI-SF total score was higher in the cesarean section group than in the vaginal delivery group (adjusted = 0.24, SEM = 0.09). This increase was primarily due to higher scores for the difficult child factor (adjusted = 0.18, SEM = 0.05) and not to higher scores for the parental distress or spouse factor.
Cesarean section was associated with higher parenting stress, especially in relation to the difficult child factor. Our results highlight the importance of paying particular attention to the mental health of both mother and child in the case of cesarean section.
越来越多的证据表明剖宫产对母婴存在长期健康风险，但鲜有研究探讨剖宫产与育儿压力之间的关系。在这里，我们利用一个大型数据集来研究这种关联。
参与者为参加日本环境与儿童研究的 65235 名母亲，这是一项正在进行的全国性出生队列研究。结局变量是使用日本 19 项育儿压力指数短表（J-PSI-SF）的总评分和子量表评分（代表困难儿童、父母困扰和配偶因素）评估的育儿压力。暴露因素为分娩方式、J-PSI-SF 评估时间（产后 1.5、2.5 和 3.5 年）以及两者之间的交互作用。多变量回归分析用于计算调整后的系数和均数的标准误（SEM）。
剖宫产组的 J-PSI-SF 总评分高于阴道分娩组（调整后 = 0.24，SEM = 0.09）。这种增加主要是由于困难儿童因子的评分较高（调整后 = 0.18，SEM = 0.05），而不是父母困扰或配偶因子的评分较高。
剖宫产与育儿压力增加相关，尤其是与困难儿童因子相关。我们的研究结果强调了在剖宫产情况下特别关注母婴心理健康的重要性。
